PayerIQ
Production
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Tier 3MNBCBS

Medical Mutual of Ohio

Monitor & nurture — quarterly touchpoints + data sharing

Composite
56.3
Rank
#175
Members
6.4M
Scoring profile

Six-criterion radar

Breakdown

Weighted score contribution

Claims
25%
37
+9.3
Lives
20%
75
+15.0
Geography
20%
68
+13.6
Restrictions
15%
18
+2.7
Relationship
10%
57
+5.7
Financials
10%
100
+10.0
Composite Score56.3
Composite = Claims×0.25 + Lives×0.20 + Geography×0.20 + Restrictions×0.15 + Relationship×0.10 + Financials×0.10
= 9.3 + 15.0 + 13.6 + 2.7 + 5.7 + 10.0 = 56.3
Intelligence

Qualitative intelligence

Members
6.4M
Drug spend
$2.2B
Formulary
3-tier
PA / RA level
Moderate
Biosimilar policy
Preferred substitution
Avg reimbursement
61 days
Strategic notes

Outperforms nationals in local market; key state champion opportunity

Peer set

Closest peers in BCBS

Anthem Blue Cross Blue Shield New Hampshire
TX · Tier 3
56.5
+0.3
Arkansas Blue Cross and Blue Shield HMO
TX · Tier 3
56.8
+0.5
CareFirst BlueCross BlueShield
MO · Tier 3
57.6
+1.4
Blue Cross Blue Shield of Michigan
WV · Tier 3
54.6
-1.6
Blue Cross Blue Shield North Dakota
MA · Tier 2
58.5
+2.3
Playbook · Tier 3

Engagement timeline

Week 2
Account manager check-in
Bi-annually
Formulary monitoring report